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Long‐term double‐blinded unilateral pedunculopontine area stimulation in Parkinson's disease
Author(s) -
Mestre Tiago A.,
Sidiropoulos Christos,
Hamani Clement,
Poon YuYan,
Lozano Andres M.,
Lang Anthony E.,
Moro Elena
Publication year - 2016
Publication title -
movement disorders
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.352
H-Index - 198
eISSN - 1531-8257
pISSN - 0885-3185
DOI - 10.1002/mds.26710
Subject(s) - parkinson's disease , interquartile range , pedunculopontine nucleus , deep brain stimulation , medicine , gait , physical medicine and rehabilitation , physical therapy , refractory (planetary science) , quality of life (healthcare) , movement disorders , disease , surgery , physics , nursing , astrobiology
ABSTRACT Background Gait‐related symptoms are often refractory to current available treatment options with a significant reduction in quality of life in Parkinson's disease. Objectives The objective of this study was to determine the long‐term efficacy and safety of unilateral pedunculopontine area stimulation for refractory gait and balance impairment in Parkinson's disease. Methods This study used periodic randomized double‐blinded assessments until 4 years postoperatively. The primary outcomes were gait‐related items of the UPDRS part II and the MDS‐UPDRS part III. Results At baseline, the median age and disease duration was 63 years (interquartile range: 62, 65) and 15 years (interquartile range: 11, 20). At 2 years, patient‐reported freezing (UPDRS part II, off‐time) was significantly better when compared with baseline ( P =.028), with 62.5% of responders. At 4 years, there was no significant change in the used outcomes, but 66.7 % (n = 4 of 6) were responders for off‐time patient‐reported freezing and falling. Conclusions Pedunculopontine area stimulation has an initial but not sustained benefit for gait‐related symptoms. © 2016 International Parkinson and Movement Disorder Society